Environmental Press, Aging in Place, and Residential Satisfaction of Urban Older Adults

Sociologists who study and work with older adults often use the term “aging in place” when discussing older adults' residential environments. Aging in place suggests that what is best for older people (and society at large) is to remain in the residential environment (e.g. home and neighborhood) in which they have lived most of their lives. The goal of this study was to utilize the theory of environmental press in a sample of older adults living in the central city of Detroit to begin to understand their levels of satisfaction with their residential environment, and to examine potential limitations in the theory of aging in place.

A random telephone survey was used in a sample of older adults (n = 604) living in the central city of Detroit, Michigan. Hierarchical logistic regression was used to test residential satisfaction using demographics, home hazards, neighborhood hazards, personal competencies, geographic location, and interaction variables. Home hazards, neighborhood hazards, geographic location, and interaction press measures predicted housing satisfaction (Nagelkerke R2=40.2 percent) and neighborhood satisfaction (Nagelkerke R2=50.5 percent). The environmental press and residential satisfaction of the highest and lowest mentally and physically functioning older adults were also investigated. Respondents who reported the lowest levels of mental and physical functioning also reported the lowest levels of residential satisfaction and faced the greatest environmental challenges. The results suggest that older adults occupying disadvantaged social locations may be overlooked in current practice definitions of aging in place.

Identifying relationships between symptom clusters and quality of life in adults with chronic mixed venous and arterial leg ulcers

The objective of this study was to identify symptom clusters and their effect on quality of life (QOL) of adults with chronic leg ulcers of mixed venous and arterial aetiology. A secondary analysis of data from four existing prospective longitudinal studies conducted by a wound healing research group in Australia was undertaken. A total of 110 patients who met the inclusion criteria were selected for this study. Exploratory factor analysis (EFA) was used to identify symptom clusters and correlational analyses to examine relationships between the identified symptom clusters and QOL. The EFA identified two distinct symptom clusters: a 'systemic symptom cluster' consisting of pain, fatigue and depressive symptoms; and a 'localised-leg symptom cluster' including pain, fatigue, oedema, lower limb inflammation and exudate. Physical QOL correlated significantly with the systemic symptom cluster (r = -0·055, P < 0·0001) and the localised-leg symptom cluster (r = -0·054, P < 0·0001), whereas mental QOL was associated only with the systemic symptom cluster (r = -0·038, P = 0·01). The results suggest that appropriate intervention strategies targeting specific symptom clusters should be developed. Targeting patients with symptom clusters is particularly important because they are at high risk and the most vulnerable for reduced QOL.

The role of caregiver burden in understanding African American custodial grandmothers

African American grandmothers who parent their grandchildren often experience burden and altered health related to these responsibilities. However, little is known about how such burden reliably predicts physical and mental health, needs for information about services, needs for service and service use. Recruited from churches and community centers, 93 African American grandmothers who provided care for their grandchildren participated in this study. Hierarchical multiple regression was used to ascertain relationships between variables. Findings suggested that burden predicted needs for information about services, needs for service, service use, and physical health, but not mental health. In order to better understand grandmother caregivers' well-being and orientation to services, the present study suggests that the role of burden be centralized as a predictor of many parameters pertinent to grandparents raising their grandchildren.

Types and Factor Structure of Barriers to Utilization of Health Services among Aging South Asians in Calgary, Canada

Souvent, les personnes aînés de groupes ethniques minoritaires éprouvent obstacles différents à l’access aux services de santé. Généralement, les études ont porté sur les groupes combinés d’immigrants âgés ou sur minorités ethno-culturels importantes, tels que les Chinois au Canada ou les Afro-américains et Latino-Américains aux États-Unis. Cette étude visait à examiner les types des facteurs qui constituent des obstacles à l’utilization des services de santé rencontrés à Calgary, Alberta, Canada, par les immigrés vieillissants d’Asie du Sud. Un sondage téléphonique a été utilisé pour rassembler des données d’un échantillon aléatoire d’immigrants d’Asie du Sud âgés de 55 ans et plus. L’analyse des éléments principaux a révélé quatre types principaux d’obstacles: l’incompatibilité culturelle; les attitudes personnelles; les problèmes administratifs dans la livraison et les défis posés par les circonstances.

Assessing racial health inequality in older adulthood: comparisons from mixed-mode panel interviews

OBJECTIVES

Estimates of the extent of health disparities among Black and White older adults are not consistent across studies. The purpose of this study was to systematically compare responses from Black and White older adults in telephone and face-to-face interviews in order to determine whether estimates of racial health inequality vary by survey interview mode.

METHODS

By using data from a mixed-mode panel study, I compared estimates of changing health inequality for Black and White older adults collected from face-to-face and telephone interviews. I calculated trajectories of physical disability by using latent growth models across seven waves of data.

RESULTS

Face-to-face interviews yielded consistently higher reports of disability relative to telephone interviews of the same persons. Black adults had significantly greater and increasing disability than did White adults for both interview modes. After adjusting for covariates, I found that Black and White older adults had parallel disability trajectories in face-to-face interviews but a widening gap in disability over time in telephone interviews.

DISCUSSION

Researchers should judiciously consider whether estimates of racial health inequality-and change in disability more broadly-may be misleading because of interview-mode effects.

Assessing the reliability and validity of the John Henry Active Coping Scale in an urban sample of African Americans and white Americans

OBJECTIVES

The primary focus of this study was to examine the psychometric properties of the John Henry Active Coping scale (JHAC12) among an urban middle-aged sample of African Americans and white Americans.

DESIGN

The sample consisted of 75 African Americans and 129 white Americans from South Florida ranging in age from 25 to 54 years. Subjects completed the JHAC12, the Life Orientation Test (LOT), Coping Orientation to Problems Encountered (COPE) subscales, and the Marlowe-Crowne Social Desirability scale.

RESULTS

Major findings supported the validity and reliability of the JHAC12 among both African Americans and white Americans. For both the African American and white American subsamples, the JHAC12 was correlated with the active coping and suppression of competing activities subscales of the COPE and negatively correlated with the Marlowe-Crowne Social Desirability scale. In the African American subsample the JHAC12 was positively correlated with the LOT. The JHAC12 was also negatively associated with the behavioral disengagement subscale of the COPE among white Americans. Multiple regression analyses revealed that the proportion of variance in the JHAC12 explained by the various subscales of the COPE, Marlowe-Crowne, and the LOT was 43% for African Americans and 20% for white Americans. Factor analyses suggested two similar and meaningful factors among the African American and white American subsamples. Finally, Cronbach alpha reliabilities revealed similar subsample coefficients.

DISCUSSION

The implications of the findings are discussed in terms of the JHAC12's ability to assess the construct of active coping among African Americans and white Americans.